I recently saw a patient who said that she boarded a flight with no symptoms, but immediately after the plane got into the air, she felt a toothache so bad she thought she was going to pass out. Have you ever felt a sudden toothache while flying, or noticed that a dental problem seems worse after a long trip? This is not your imagination.
Changes in cabin air pressure, dry air, and stress during air travel can aggravate existing oral conditions, turning a mild or silent problem into noticeable pain.
The most well-known example is barodontalgia, sometimes called ‘aviator’s toothache’. It is dental pain triggered by changes in atmospheric pressure during ascent or descent.
This is not a disease in itself, but rather a manifestation of an underlying oral problem that was already present, such as tooth decay, a failing filling, an inflamed or dead nerve, infection at the root tip, gum disease, or an impacted tooth.
As the plane climbs, outside pressure drops, and any air trapped in a cavity, under a filling, or inside a tooth can expand, pressing on nerves and causing sharp pain.
During descent, the reverse can happen, with pressure changes again irritating sensitive tissues. Sinus congestion or sinusitis can also cause ‘indirect’ barodontalgia, where pressure on the sinuses causes referred pain to the upper teeth.
Additionally, the cabin environment is very dry, with low humidity that can reduce saliva production. Saliva plays a key role in protecting teeth by neutralising acids, washing away food particles, and limiting bacterial growth.
When saliva is reduced, the mouth becomes more prone to dryness and irritation, and existing gum disease or tooth sensitivity may worsen.
If you have recently had dental treatment, especially surgery, extractions, or work involving the sinuses, flying too soon afterwards can increase the risk of complications.
Air trapped in healing tissues or sinus spaces can expand with pressure changes, causing pain, swelling, or even barotrauma. It is generally advised to wait at least two weeks after dental procedures and ensure there are no sinus symptoms before flying.
Practical tips
Address known dental problems before travel: Treat cavities, infections, or gum disease early.
Stay hydrated: Drink plenty of water to counteract dry cabin air and support saliva production.
Chew sugar-free gum: This stimulates saliva and helps equalise pressure in the ears and sinuses during take-off and landing.
Manage sinus congestion: If you have a cold or sinusitis, consider a decongestant before flying, following medical advice.